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骨髓多能干细胞动脉灌注治疗股骨头坏死的实验研究
引用本文:季卫锋,童培建,郑文标,厉驹,肖鲁伟.骨髓多能干细胞动脉灌注治疗股骨头坏死的实验研究[J].中国中西医结合杂志,2004,24(11):999-1002.
作者姓名:季卫锋  童培建  郑文标  厉驹  肖鲁伟
作者单位:1. 浙江中医学院附属医院骨伤科,杭州,310006
2. 浙江省台州市立医院骨科
基金项目:国家中医药管理局资助项目
摘    要:目的探讨骨髓多能干细胞动脉灌注治疗股骨头坏死的疗效和机理研究。方法利用Shwartzman反应加大剂量甲基强的松龙造成兔股骨头坏死模型,造模成功后在兔股骨抽取骨髓,进行体外分离培养骨髓多能干细胞,使之大量增殖。兔随机分为4组:对照组(注射生理盐水)、丹参组(注射丹参和尿激酶)、干细胞组(注射骨髓多能干细胞)、综合组(注射骨髓多能干细胞、丹参和尿激酶),于治疗后的2、4周分批处死动物后进行各种指标检测,包括X线钼靶摄影、常规HE染色切片、四环素标记荧光显微镜观察、电镜扫描超微结构观察。结果兔造模成功后出现股骨头坏死表现,高选择性旋股内、外动脉插管药物治疗后2、4周,X线表现骨质密度改变明显好转。病理组织学表现空骨陷窝减少,成骨细胞增多,新骨形成。四环素荧光标记显示坏死修复区荧光带鲜亮,边界增宽。电镜扫描下可见坏死区纤维组织杂乱,成骨细胞内细胞器丰富,空骨陷窝减少。经多能干细胞动脉灌注治疗后显示在时间和效果方面更优越。结论高选择性股动脉灌注药物治疗股骨头坏死能加速兔股骨头的再血管化和再骨化进程。骨髓多能干细胞比丹参显效时间更快捷,疗效更显著。

关 键 词:股骨头坏死  多能干细胞  动脉灌注  骨生成
修稿时间:2004年2月2日

Experimental Study on Treatment of Femoral Head Necrosis with Arterial Perfusion of Marrow Stem Cells
Authors:JI Wei feng  TONG Pei jian  ZHENG Wen biao
Abstract:To explore the effect of arterial perfusion of marrow multifunctional stem cells (MFSC) in treating femoral head necrosis and its mechanism. MethodsThe rabbit model of femoral head necrosis was established by large dose of methyl prednisone through Shwartzman response. Bone marrow was extracted from femoral bone of model rabbit and isolated in vitro for culturing and proliferating MFSC. The experimental rabbits were randomly divided into 4 groups, treated with normal saline (A), Salvia urokinase (B), MFSC (C) and MFSC Salvia urokinase (D), respectively, they were sacrificed in batches at 2 and 4 weeks after treatment, and changes in various parameters, including molybdenum target roentgenogram, routine pathology with HE staining, tetracycline labeled fluorescent microscopy and ultrastructure alteration by scanning electron microscope (SEM), were observed. Results Typical appearance of femoral head necrosis was shown in the successfully modeled rabbits. Two and 4 weeks after treatment by high selective drug via medial and lateral femoral circumflex arterial perfusion, the X ray examination showed significant improvement of bone density; pathohistologic manifestation showed decrease of empty bone lacuna, increase of osteoblast and new bone formation; tetracycline fluorescent labeled microscopic picture showed bright fluorescent band of increased osteoblasts in necrosis repairing region with widened border; SEM displayed irregularly arranged fibrosis in necrosis region, abundant organelles in osteoblasts with few empty bone lacuna. The above mentioned improvement was more significant in rabbits treated by MFSC. ConclusionHigh selective femoral drug arterial perfusion in treating femoral head necrosis could accelerate the process of revascularization and re ossification in rabbits. As compared with Salvia, MFSC showed quicker and more potent effect.
Keywords:femoral head necrosis  multifunctional stem cell  arterial perfusion  osteogenesis
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